其症恶寒发热，或腹痛，似疟非疟，气急喘逆，头面肿胀，胸腹饱闷胀满，或泄泻下痢脓血。
轻者牵连弥月，重者危急一时。治宜放痧，消食积为主，俟痧毒已泄，然后和解清理除其寒热，
健脾养血补其中虚。
凡痧有青筋、紫筋，或现于数处，或现于一处。必用针去其毒血，然后据症用药。（按∶轻者
针即见效，不用服药。）
一在头顶心百会穴。一在两眉中间印堂。一在两眉稍洼陷处太阳穴。一在结喉两旁。一在舌
底下筋之两旁。一在双乳。（以上俱斜挑。）一在两手背十指尖当中近甲薄肉。一在两臂湾。
一在两足背十指尖当中近甲薄肉。一在两腿湾。（以上但直刺。）
（原作刺痧，今改作放字，兼挑与刺二字言之。）
腿湾上下有细筋，深青色或紫色，或深红色者便是。（皮白嫩者方显紫红色。）刺之则有紫黑毒
血。腿上大筋不可刺，刺亦无毒血，反令人心烦，两腿边硬筋上筋不可刺，（硬筋，腿之大粗筋。
其上筋，乃指靠皮之小筋言。）刺之恐令人筋吊，（缩也。）手臂筋色亦如此辨之。至于宜针挑
者，唯取挑破皮略见血。（如无血，手挤之。）至于指尖刺之太近指甲，令人头眩。凡刺不可太
深，银针方佳，铁性有毒。
锦按∶两腿湾、两臂湾，止此二处宜寻痧筋刺之。余处亦不言痧筋，是无痧筋也。只按穴放
之可耳。法有直刺、斜挑之异，故以放字该之。至于挑法，亦
当有随症施治者，如头痛则挑印堂及太阳穴，胃痛则挑心窝，腹痛则绕脐挑之。胁痛则密挑两肋
以及挑肩井穴，挑背挑项，挑耳尖耳叶，挑腰挑软肋，（数处皆诸痧必挑之穴。）俱用针斜挑皮挤血。
至于少商穴及两手足指尖，乃系直刺，如无血亦须挤之。
其症状表现为恶寒发热，或伴有腹痛，症状类似疟疾但又不完全是疟疾，气息急促、气喘逆乱，头面部肿胀，胸部和腹部饱闷胀满，或者出现腹泻、痢疾并排出脓血。
病情较轻的，病程可能延续一个月；病情严重的，短时间内就会危及生命。治疗应当采用放痧法，以消除食积为主，等到痧毒已经宣泄之后，然后再使用和解的方法清除寒热，健脾养血以补益中气的虚弱。
凡是痧症，会出现青色或紫色的筋络，有时出现在多处，有时只出现在一处。必须用针具刺破以去除毒血，然后根据具体症状来用药。（按语：轻症患者针刺后立即见效，不需要再服药。）
取穴位置包括：头顶正中的百会穴。两眉中间位置的印堂穴。两眉梢凹陷处的太阳穴。喉结两侧的位置。舌头底下筋络的两侧。双乳部位。（以上穴位均采用斜挑法。）两手手背十指指尖之间靠近指甲的薄肉处。两肘窝（手臂弯曲处）。两足手背十指指尖之间靠近指甲的薄肉处。两膝窝（腿部弯曲处）。（以上穴位仅采用直刺法。）
（原著中称为“刺痧”，现在改为“放”字，兼括挑法和刺法两种含义。）
腿弯上下若有细筋，颜色呈深青色、紫色或深红色的，就是需要治疗的部位。（皮肤白皙嫩滑的人，才会显现出紫红色。）针刺后会流出紫黑色的毒血。大腿上的大筋不可针刺，即使针刺也没有毒血流出，反而会使人心烦意乱；小腿边缘硬筋上的小筋也不可针刺。（所谓硬筋，是指腿上最粗的大筋；其上的小筋，是指贴近皮肤的小筋。）如果针刺这些部位，恐怕会导致筋脉拘挛收缩。（即抽筋的意思。）手臂上的筋络也以此类推进行辨别。至于适宜用针挑的部位，只需挑破皮肤略微见血即可。（如果没有血，用手挤压使其出血。）如果针刺指尖时过于靠近指甲，会导致人头晕目眩。凡是用针刺都不可太深，使用银针最好，因为铁性有毒。
锦按语：两腿弯、两臂弯，只有这两处适合寻找痧筋进行针刺。其他部位如果不提及痧筋，说明那里没有痧筋。只需按照穴位进行放血即可。方法有直刺和斜挑的区别，所以用“放”字来概括。至于挑法，也应当根据症状灵活施治，例如头痛就挑印堂穴和太阳穴，胃痛就挑心窝部，腹痛就围绕肚脐周围挑治。胁痛就密集挑治两肋以及肩井穴，背部疼痛挑背部和颈部，耳朵疼痛挑耳尖和耳垂，腰部疼痛挑腰部和软肋。（这几个部位都是各种痧症必须挑治的穴位。）均使用针具斜挑皮肤并挤压出血。至于少商穴以及两手足的指尖，则是采用直刺法，如果没有血也必须挤压出来。
The symptoms manifest as aversion to cold and fever, or abdominal pain, resembling malaria but not exactly so, with rapid breathing and wheezing, swelling of the head and face, fullness and distension in the chest and abdomen, or diarrhea and dysentery with pus and blood in the stool.
Mild cases may persist for a month, while severe cases become critical within a short time. Treatment should prioritize Fangsha (bloodletting for sha disease) to resolve food stagnation. Once the sha toxin has been vented, then employ harmonizing methods to clear cold and heat, and strengthen the spleen and nourish blood to tonify the deficiency of the middle jiao (middle burner).
In sha disease, cyanotic or purple veins may appear, either in several locations or just one. It is essential to use needles to remove toxic blood, and then prescribe medication based on the specific symptoms. (Note: For mild cases, needle treatment yields immediate results, and no further medication is needed.)
Acupoints include: Baihui (DU20), located at the center of the vertex. Yintang (EX-HN3), located between the two eyebrows. Taiyang (EX-HN5), located in the depression at the outer ends of the eyebrows. Both sides of the laryngeal prominence. Both sides of the veins under the tongue. The breasts. (All these points are treated with oblique picking/scratching.) The thin skin between the fingertips on the dorsum of both hands, near the nails. Both cubital fossae (elbow creases). The thin skin between the fingertips on the dorsum of both feet, near the nails. Both popliteal fossae (knee creases). (These points are treated only with perpendicular insertion.)
(The original text refers to this as "Ci Sha" (puncturing sha), now changed to "Fang" (release/vent), encompassing both picking and puncturing techniques.)
Fine veins above and below the knee creases that are deep cyanotic, purple, or deep red indicate the presence of sha. (In individuals with fair and tender skin, purple-red coloration becomes visible.) Puncture will yield dark purple-black toxic blood. Do not puncture the large tendons of the thighs; puncturing them yields no toxic blood and may instead cause restlessness. Do not puncture the small veins lying superficially on the hard tendons along the sides of the legs. (The "hard tendon" refers to the largest thick tendon of the leg; the "superficial vein" refers to the small veins close to the skin.) Puncturing these may lead to tendon contraction (cramping). The veins in the arms are identified similarly. For areas suitable for needle picking, merely break the skin until slight bleeding occurs. (If there is no blood, squeeze manually.) Puncturing too close to the nail on the fingertips may cause dizziness. Needles should not be inserted too deeply; silver needles are preferred because iron possesses toxic properties.
Jin's Note: Only the bilateral popliteal fossae and cubital fossae are suitable for seeking out sha veins for puncture. In other areas, if sha veins are not mentioned, it implies their absence. One need only perform bloodletting according to the acupoints. Methods vary between perpendicular insertion and oblique picking, hence the term "Fang" (release) covers both. Regarding picking techniques, treatment should also be adapted to symptoms: for headache, pick Yintang and Taiyang; for stomachache, pick the epigastrium; for abdominal pain, pick around the umbilicus. For hypochondriac pain, densely pick both flanks and Jianjing (GB21); for back and neck pain, pick the back and neck; for ear pain, pick the auricular apex and lobule; for waist pain, pick the waist and soft ribs. (These sites are all mandatory points for various sha diseases.) Use needles to obliquely pick the skin and squeeze out blood. Shao Shang (LU11) and the fingertips of both hands and feet are treated with perpendicular insertion; even if there is no blood, it must be squeezed out.